Healthy skin is:

Smooth, with no breaks in the surface

Warm, but not hot

A reflection of a healthy body

Healthy skin is not:

Red

Rough

Flaky

Itchy

Dry

Irritated

Our products

Coloplast is dedicated to creating and providing innovative products focused on maintaining and caring for the skin. Our skincare products provide protection for vulnerable skin as well as treating and taking care of a variety of skin issues.

Skin care steps

Some of the strongest available evidence associated with maintaining optimal skin health and preventing skin complications supports the use of a structured skin care regimen and quality products (1). At Coloplast, we believe that a simplified, structured regimen decreases variations in the delivery of care among staff and promotes compliance for optimal outcomes (2).

A structured skin care regimen includes three elements of care: Cleanse, Moisturize, and Protect.

Cleanse

The first step in maintaining and promoting optimal skin health is to cleanse. Throughout the day, skin wastes and environmental contaminants can accumulate on the skin. As a result, skin cleansers should be used at regular intervals. To minimize potential skin sensitivities, allergens, or skin irritations, select a mild skin cleanser that is pH-balanced and made with few ingredients. Cleansing of the body should be gentle, without scrubbing. Once cleansed, gently pat dry.

If skin is soiled from urine or stool, cleanse the skin frequently with a no-rinse, pH-balanced skin cleanser. Select a no-rinse cleanser that is a mild synthetic surfactant with emollients and humectants that cause minimal barrier disruption to the stratum corneum.

Moisturize

The second step in maintaining and promoting optimal skin health is to moisturize. Select a product free of potential irritants or scents. Moisturizing the skin routinely, especially after bathing, can help reduce the risk of skin complications, such as dry skin, skin tears, and skin breakdown. Friction injuries may also be reduced by the use of moisturizers.

Protect

The final step in maintaining and promoting optimal skin health is to protect. Exposure to irritants and excess moisture from urinary and/or fecal incontinence can lead to painful dermatitis, skin breakdown, and Moisture Associated Skin Damage (MASD). Skin barriers isolate the skin’s exposure to these elements. An ideal moisture barrier has few ingredients and shields the skin from irritants and excess moisture, maintains skin hydration, and avoids maceration. Skin protectant ingredients include petrolatum, dimethicone, or zinc oxide.

Intertrigo (or intertriginous dermatitis) is a rash that can develop in a skin fold. The condition is common and may affect people from infancy to adulthood. Certain factors increase your risk, such as having diabetes, being overweight, incontinence (unable to control bladder or bowels), wearing incontinence briefs or being on bed rest.

Perspiration, warmth and friction can cause a skin fold to become red and inflamed. Symptoms such as itching, burning, odor and pain can accompany the redness. These symptoms can also occur under medical devices such as braces or splints, or adjacent to artificial limbs.

Common areas for intertrigo

Intertrigo may potentially develop in any skin fold or in areas where there is constant skin-on-skin friction (1). It may be found:

Between thighs

Under the armpit

Under breasts

Around belly folds

Between fingers and toes

In groin folds

In neck creases

Behind the knee

Adjacent to an artificial limb

Under a brace or splint

Other problems in skin folds

In someone who is incontinent, moisture from urine and stool can get trapped in skin creases. This may be found especially under the buttocks. The condition that develops is not intertrigo, but it is a type of dermatitis that can cause similar problems. When skin or a skin fold is moist and/or damaged, it is prone to infection from bacteria or fungus (1).

How to minimize the risk

For general prevention, patients should try to keep skin folds clean and dry, decreasing moisture and rubbing between folds of skin with a wicking fabric containing silver (2). InterDry® Textile with Antimicrobial Silver Complex is a wicking textile that removes excess moisture, reduces friction and contains silver to help manage fungal or bacterial infections (3). It’s also a good idea to wear lightweight, loose and absorbent clothing (4).

Caring for your skin

If intertrigo does develop, consider following these recommended steps until the rash disappears.

Step 1: Wash the skin fold

Wash gently, using a pH-balanced skin cleanser. Some options include a no-rinse body wash or no-rinse incontinence cleanser.

Pat your skin dry. Do not rub.

Step 2: Protect your skin

Cut the appropriate size textile with scissors, allowing for a minimum of 2 inches of textile exposure outside the skin fold.

Lay a single layer of textile into the base of the skin fold or under a medical device such as a brace or splint. Leave at least 2 inches of the textile exposed outside the skin fold or brace/splint. This allows the excess moisture to wick away from the skin fold and evaporate.

Secure the textile in one of several ways: with the weight of the skin fold, with a small amount of tape or tucked into clothing.

Remove the textile before bathing and insert back when when finished.

Replace the textile in 5 days or if it becomes soiled with urine or stool.

Patients should be sure to check their skin every day. They should look for rashes, redness or open areas and inspect all skin folds, or under devices that rub against the skin.

Dry skin is a common problem caused by loss of the skin’s natural moisturisers, leading to epidermal water loss. The environment plays an important role in this water loss. During winter, or with the use of central heating or air conditioning, skin loses moisture more readily. Similarly, frequent bathing or using harsh soap product may increase the risk of dry skin.

Dry skin is most often found on the lower legs and feet and less often on the trunk of the body or hands. The skin may be scaling and flaking, it may appear dull with a grey or whitish discoloration, or you may see increased skin markings or lines. In severe cases, deep cracks, warmth, pain and redness may be evident. The presence of rough, uneven or cracked skin indicates a need for intervention.

Dry skin can be classified as mild, moderate, or severe. It is more easily eliminated or controlled when in the mild to moderate stages.

Caring for dry skin

Dry skin, or xerosis, requires proper care just as moist skin does. Choosing the best type of moisturiser is important. For instance, water-based moisturisers require frequent application, often with little improvement. Oil-based creams and lotions that trap moisture in the skin and require less frequent application are more effective.

Follow these steps to care for dry skin:

Cleanse - gently cleanse the skin with a mild, pH-balanced skin cleanser and a soft cloth or disposable washcloth.

Pat skin dry. Do not rub.

Moisturise the skin - apply moisturising creams or lotions after bathing as needed.

A pressure ulcer, also called a bedsore or pressure sore, is an injury to the skin due to constant pressure. Pressure ulcers form when blood flow to the area slows or stops. This causes small portions of the tissue to die, and an ulcer develops.

Pressure ulcers typically form over bony parts of the body. Damage to skin can occur when these bony parts of the body press against a hard surface. Hard surfaces include beds, chairs or even medical devices, such as a brace or splint.

Incontinence is the difficulty or inability to control your bladder (urine) or bowel (stool). The ailment is common, but those who experience it are often too embarrassed to ask for help.

Although incontinence is more common in the elderly population, it is not part of the normal aging process. Urinary incontinence may be caused by medical problems such as weak pelvic muscles, diabetes or an enlarged prostate gland. It can also be caused by certain medications. Common causes of faecal incontinence include constipation, diarrhoea or damage to the anal sphincter muscles from giving birth. It can also be caused by an improper diet or certain medications.

How incontinence affects the skin

If your patient experiences incontinence, it is very important that they know how to protect their skin from damage. Skin provides the first line of defence against germs and infection, and long-term exposure to moisture from urine or stool can cause the skin to soften, weakening the skin’s ability to serve as a protective barrier.

With frequent incontinence, skin problems can occur. Typical symptoms are redness, burning and irritation around the buttocks, rectum, groin, or between the thighs. If there is persistent moisture from urine and stool, it increases the risk of infection and/or skin breakdown.

Caring for the skin

If your patient does suffer from incontinence-related skin problems, they should follow the steps below to ensure proper skin care.

Step 1: Clean your skin

Remove and throw away the brief, pad or other soiled material.

Wash your skin each time it has been soiled. Use a pH-balanced, no-rinse skin cleanser. TIP: Avoid harsh soaps like bar soap and antimicrobial hand-washing soaps. These can dry the skin and lead to skin breakdown. (1)

Gently clean the area from front to back using a soft washcloth or disposable soft cloth.

Pat your skin dry. Do not rub.

Step 2: Protect your skin

A skin protectant is a moisture barrier cream, ointment or paste. It is used to protect your skin from urine and stool. Most skin protectant ointments contain petrolatum, dimethicone, zinc oxide or a combination of these ingredients. (2)

Apply a thin, even layer of skin protectant.

Some people use absorbent underpads, or briefs. Change pad or briefs after it has been soiled. Avoid products that have a plastic lining.

Incontinence-associated dermatitis (IAD)

Caustic moisture damage: stool/urine

(More commonly known as diaper rash). Inflammation of the skin that occurs when urine or stool comes into contact with perineal/perigenital area, inner thighs, buttocks, or adjacent skin folds. Characteristics include inflammation and erythema with or without erosion or denudation.

Periwound moisture-associated dermatitis

When wound exudate has sustained contact with the skin, skin damage is the likely outcome. Characteristics include inflammation and erythema with or without erosion.

Interventions

Assess cause of periwound damage. If wound is exuding large amounts of exudate, consider using an absorbent dressing (Biatain Family of dressings)

Cleanse the wound at time of each dressing change with a saline-based wound cleanser (Sea-Clens® Wound Cleanser). Pat the periwound edges dry.

Apply protective skin barrier to the periwound edges.

Let dry and then re-apply.

Peristomal moisture-associated dermatitis

Caustic moisture damage: stoma effluent

Inflammation around a stoma due to sustained contact of stool or urine on the peristomal skin.

Interventions

Assess cause of peristomal damage.

Prevent any further damage (i.e., cut ostomy barrier to size, change pouch according to schedule, change pouch immediately for burning or irritation).

Gently wash the peristomal skin before applying a new pouching system. Pat dry.

If skin is moist and weepy, consider managing with crusting technique (Ostomy Powder).

Candidiasis

Yeast infection

A yeast infection of the skin caused by candida fungus. Commonly found in warm, moist areas, such as skin folds. Characteristics include small pustules and a macerated beefy red rash with satellite lesions.

Interventions

To exfoliate extremely dry/fissured skin, such as heels use moisturiser with urea and lactic acid (Atrac-Tain® Cream).

Erythrasma

A bacterial infection caused by corynebacterium minutissimum. Characteristics include a reddish-brown, slightly scaly patch with sharp borders, occurring in moist areas such as the groin, axilla, and skin folds. Pruritus may be present.